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同步早发性头颈部癌与食管癌术前化疗后是否需要治疗?

Does synchronous early head and neck cancer with esophageal cancer need treatment after preoperative chemotherapy?

机构信息

Department of Esophageal Surgery, National Cancer Center Hospital, 5-5-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.

Course of Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Japan.

出版信息

Gen Thorac Cardiovasc Surg. 2022 Mar;70(3):280-284. doi: 10.1007/s11748-021-01744-9. Epub 2021 Nov 27.

Abstract

OBJECTIVE

Treatment options for patients with resectable thoracic esophageal squamous cell cancer (ESCC) and synchronous head and neck cancer (HNC) are unclear. Little has been reported about the effects of chemotherapy on early HNC. The aim of this study was to investigate the treatment outcomes of resectable thoracic ESCC with synchronous early HNC.

METHODS

We retrospectively reviewed 37 patients undergoing esophagectomy for thoracic ESCC with synchronous early HNC from January 2008 to December 2018.

RESULTS

Among 37 patients who had synchronous early HNC, 27 patients received preoperative therapy for ESCC before HNC treatment, and 16 of 27 patients achieved a complete response for HNC by preoperative chemotherapy. Fifteen of 16 patients did not receive additional treatment, and regional recurrence of HNC was not observed. In one other case, an oral excision was performed, but no cancer cell remnants were found pathologically. No significant difference in overall survival and disease-free survival was observed between 15 patients with follow-up and 22 patients with surgery or radiation.

CONCLUSION

Our results indicate that early HNC with comorbid ESCC could be followed up without additional treatment if preoperative chemotherapy is successful.

摘要

目的

可切除的胸段食管鳞癌(ESCC)和同步头颈部癌(HNC)患者的治疗选择尚不明确。关于化疗对早期 HNC 的影响报道较少。本研究旨在探讨可切除的胸段 ESCC 合并早期 HNC 的治疗效果。

方法

我们回顾性分析了 2008 年 1 月至 2018 年 12 月期间 37 例接受胸段 ESCC 切除术合并早期 HNC 的患者。

结果

在 37 例合并早期 HNC 的患者中,27 例在 HNC 治疗前接受了术前 ESCC 治疗,27 例患者中有 16 例通过术前化疗实现了 HNC 的完全缓解。16 例患者中有 15 例未接受额外治疗,且未观察到 HNC 的区域性复发。另 1 例患者行口腔切除术,但病理检查未发现癌细胞残留。在随访的 15 例患者与接受手术或放疗的 22 例患者之间,总生存和无病生存无显著差异。

结论

我们的结果表明,如果术前化疗成功,合并可切除 ESCC 的早期 HNC 可以不进行额外治疗而进行随访。

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